Oral health status weighs heavy amongst the obese: Study

The findings add to the list of conditions that arise from weight mismanagement that include cardiovascular, neurological, digestive and skeletal-related difficulties.

Common risk factors link both oral and general health, with mechanisms that include poor oral health’s role in promoting obesity or vice versa.

The relationship may be a combination of both mechanisms as increased inflammatory markers in the blood suggest that systemic inflammation plays a key role in the process.

“Participants with a Body Mass Index (BMI) over 23.0 1 kilogram/square metre (kg/m2) had generally more severe periodontitis, total inflammatory dental diseases, and leukocyte counts than normal-weight individuals despite no significant difference on oral mucosal disorders,”​ the study demonstrated.

“The pathway leading to poor dental and periodontal health was not confounded by age and drug-induced hyposalivation, and it reflects the true association between BMI status and dental and periodontal inflammation.”​

In a study of 160 participants, with a BMI range classified as overweight (23.0–24.9 kg/m2) or obese (BMI over 25.0 kg/m2), were compared to participants with a BMI lower than 23.0 kg/m2.

Data collected included waist circumference, white blood cell count and differential white count, and levels of blood urea nitrogen, creatinine and uric acid.

Levels of triglyceride, cholesterol and systolic blood pressure and diastolic blood pressure were also noted as was the oral status and health of each subject.

All in all, 113 (70.6%) participants were overweight or had cases of dental diseases and severe periodontitis was higher in overweight or obese individuals than in normal-weight participants.

A significant difference in oral mucosal disorders between normal weight and overweight or obesity was not found.

After adjusting for age, sex, fasting plasma glucose level, smoking, and exercise, obesity was associated with an increase in severe periodontitis.

In seeking an explanation for these observations, lead study author Dr Supanee Thanakun, from the Department of Oral Medicine and Periodontology at Mahidol University in Thailand, proposed the secretion of cytokines in proportion to adipose tissue content.

“Obesity may modify the response of the host to the antigens derived from bacterial plaque and therefore cause disturbances in the inflammatory response during the process of periodontal disease,”​ he said.

Inflammatory link​

Inflammation has previously been mentioned as a contributor to obesity and oral diseases with the oral cavity affected by many disorders characterised by inflammation.

Research looking into oral mucosal lesions in elderly, smokers, or in patients with cardiovascular disease, diabetes, or metabolic syndrome found the strongest risk factors for cancer were high blood pressure and high triglycerides levels in men, and high fasting plasma glucose levels in women.

“To the best of our knowledge, no data have been previously published about oral mucosal conditions in people with various BMIs,”​ the authors commented.

“This study is the first report that reveals that there is no difference in oral mucosal conditions between normal-weight and overweight or obese patients who had not been taking any medications.”​

Previous findings​

Dr Thanakun’s suggestions have been supported by previous evidence that points to an altered oral health status in heavier individuals.

While studies​​ on periodontitis confirm the relationship between BMI and the prevalence of periodontal diseases, others​​ have found significant results only for probing depth and the plaque index, but not for periodontitis or missing teeth.

The link between dental caries with obesity is considered controversial with differences reported in the mean dental index between persons with normal weight, overweight, and obese.

These values were not statistically significant but persons with an increased BMI had a slightly worse dental caries status. 

Source: Oral Diseases​

Published online ahead of print: DOI: 10.1111/odi.12679​​

“Increased oral inflammation, leukocytes, and leptin, and lower adiponectin in overweight or obesity.”​

Authors: S Thanakun, S Pornprasertsuk-Damrongsri, Y Izumi